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Primary dapsone resistance in Cebu, The Philippines; cause for concern
E dela Cruz1, R V Cellona, M V Balagon
1Vivarium Department, Cebu Skin Clinic, The Philippines.
Summary
Primary dapsone resistance in leprosy patients in Cebu, Philippines, has surged significantly. This alarming rise threatens the effectiveness of current multidrug therapy and necessitates new treatment strategies.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Leprosy treatment relies heavily on multidrug therapy (MDT), with dapsone as a key component.
- Previous studies in Cebu, Philippines, indicated low primary dapsone resistance rates (3.6%-8.1%) between 1975 and 1982.
- The World Health Organization implemented MDT in Cebu in 1985.
Purpose of the Study:
- To assess the current prevalence of dapsone resistance in leprosy patients in Cebu.
- To evaluate the potential impact of dapsone resistance on leprosy control efforts in the region.
Main Methods:
- The study analyzed drug resistance patterns in leprosy isolates from patients in Cebu.
- Data was collected and analyzed for the period 1988-1992.
Main Results:
- A dramatic increase in primary dapsone resistance was observed, reaching 52.7% between 1988 and 1992.
- A significant proportion (7.9%) of isolates exhibited high-level dapsone resistance, a level not previously reported.
- No decline in new leprosy cases has been observed in Cebu since the implementation of MDT.
Conclusions:
- The escalating dapsone resistance poses a serious threat to the efficacy of WHO-MDT for leprosy.
- The findings suggest a link between increased dapsone resistance and the persistent incidence of new leprosy cases.
- There is an urgent need to develop and incorporate novel drugs into leprosy treatment regimens.